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Ryan Faulkner
(ryanf) - F

Locale: Mid atlantic, No. Cal
SUL gearlist on 10/06/2005 17:52:53 MDT Print View

Tis is what I take on a three season backpacking for up to 4 days on the trail reasonably good conditions

Extra clothing packed:
Under Aurmor cold gear,7.9oz
Golite wisp wind shirt,2.5oz
Bozeman Mountain Works cocoon pullover,8.5oz
fleece hat,1.5oz
wright sock double layer,1.2oz

Shelter and sllep system:
Bozeman mountain works spinn poncho,6.2oz
Gossamer gearEZC line,.9oz
Nunatak Arc Ghost,16oz
target blue foam mat cut to torso, 2.6oz

Packing:
Gossamer Gear G6 pack,3.7oz

cooking and water:
Red bull side burner,.3oz
plastic feul containerand measuring cup,.6oz
Homemade energy can pot,.6oz
KFC plactic spork,.1oz
2.4liter platypus bottle, 2oz
aqua mira in small drop bottles, 1.1oz

other essentials:
Tooth brush, dr. bronners,towel,tp,2.1oz
leatherman micra,1.7oz
target 3-led headlamp,1.5oz
homemade first aid kit,.6oz
small roll of duct tape,1.2oz
sunto a-10 compass,.8oz

TOTAL: 3.9 - 4.00

this is without food and feul and water
and dosent include clothing I wear

If you have anny improvement suggestions please feel free to reply

kevin davidson
(kdesign) - F

Locale: Mythical State of Jefferson
Ryan's gear list on 10/06/2005 18:37:31 MDT Print View

great gear list, Ryan, not Laura,afterall (noticing name confusions on other thread).

a couple of suggestions-- a balaclava would give you more warmth and protection than a fleece hat when sleeping in your Arc Ghost.

hopefully the target foam pad will be comfortable, and more importantly, warm enough. You might consider Gossamer Gear's Nightlight pad which is good to go for both.

I would love to see you list what's in your .6 oz. 1st aid kit.

Your kitchen is totally admirable.

Edited by kdesign on 10/06/2005 18:45:18 MDT.

Ryan Faulkner
(ryanf) - F

Locale: Mid atlantic, No. Cal
Re: my first aid gear list on 10/06/2005 18:51:55 MDT Print View

Thanks Kevin I found out how to change my account

Thanks you are probably right about the balaclava

and my first aid kit if very minimal
it includes

Wond clousure strips
one adhesive knee bandage
3 smaller bandage
2 2x2 gauze sponges
afew saftey pins
tweezers
tylenol
diphen
and 2 small packets of antibiotic cream

but keep in mind that you can use aqua mira as disinfectent and duct tape to close wounds

Edited by ryanf on 10/06/2005 18:56:24 MDT.

David Lewis
(davidlewis) - MLife

Locale: Nova Scotia, Canada
Re: Re: my first aid gear list on 10/06/2005 19:30:04 MDT Print View

I usually carry some liquid bandage as well. There is one brand that it sold in a tiny plastic tube... weighs just a few grams. Or you could just bring a tiny crazy glue tube.

Ryan Faulkner
(ryanf) - F

Locale: Mid atlantic, No. Cal
Re: Re: Re: my first aid gear list on 10/06/2005 19:36:12 MDT Print View

david how do you apply the liquid bandage. just squeeze it on to the cut?

David Lewis
(davidlewis) - MLife

Locale: Nova Scotia, Canada
Re: Re: Re: Re: my first aid gear list on 10/06/2005 20:03:36 MDT Print View

Yup... hold the cut closed (after cleaning it) and apply a bead. So-called "liquid bandage" is actually just crazy glue. Musicians use it all the time... like if a violinist cuts his/her finger chopping veggies the night before a gig or something. Good for small / clean cuts.

Edited by davidlewis on 10/06/2005 20:04:23 MDT.

R Alsborg
(FastWalker) - MLife

Locale: Southwest
Re: SUL gearlist on 10/06/2005 20:57:42 MDT Print View

Ryan,

You’re pretty impressive for a 14-year-old, I was in my early teens to when I got bit by the Backpacking Bug. I was first inspired by a writer named Colin Fetchers who wrote The Complete Walker (I read it a million times) and another excellent book The Thousand Mile Summer. At that time we carried an external packs, wore full grain leather high-top boots and didn’t worry about purifying water or taking a bear canister. I made a lot of my own gear sewing surplus parachutes into tents, making sleeping pads and paraffin wax stoves. Information was had mostly at the library or outdoor magazines. Things have changed some for the better some not. One of the positives is the relatively ease of acquiring the latest and greatest backpacking information regarding gear, technique, trails and weather through the Internet.

Also if you are interested in a working outdoors first try your states version of the California Conservation Corp. I did, it was a blast!

Best regards,
FastWalker

paul johnson
(pj) - F

Locale: LazyBoy in my Den - miss the forest
Re: Re: Re: Re: my first aid gear list on 10/07/2005 02:54:47 MDT Print View

[need to shorten this post & stick to the subject, so edited it somewhat].

Ryan,

use of "super"/"crazy" glue (cyanoacrylate) is an old trick. long before Doctors were using it to close some types of wounds and incisions (one type is call "Derma-bond" by medical personnel), other more resourceful types (who did not have to worry about malpractice law suits and insurance premiums) were using it when a suture kit was not available.

so, it's a legitimate suggestion. good point, David - glad you brought it up.

generally, as David pointed out, you shouldn't get it inside of the wound. i have messed up and gotten in the wound (i'm a bit of a klutz). no ill effects.

if you have a painful cut/broken blister/toe nail coming off (many other possible injuries), the superglue will stabilize the wound as well as prevent oxygen from entering it, pain is reduced markedly. i've used it to glue two big toe nails back on (amongst numerous other injuries - i'm a klutz, remember) for a period of time before the injury started to heal somewhat. you'll need to re-apply it anywhere from daily to every 3-4 days depending upon the site, nature, and severity of the injury. oh...also, because it prevents oxygen from entering the wound, it shouldn't be used to seal a puncture wound - never good to seal a puncture wound from the top. very nasty bacteria can thrive in that anaerobic (no-oxygen) environment when a puncture wound is sealed from the top. so, don't seal a puncture wound with superglue. it's difficult to thoroughly clean and disinfect a puncture wound.

also, as was previously pointed out by David, make sure the the wound is CLEAN and DISINFECTED before applying the superglue or any other bandages/wound dressings. as the wound size gets (not grows, i'm referring to the initial size of the wound) larger, it becomes much more difficult to close.

depending upon the circumstances (wound size and your location; how far to a ranger station, professional med help, etc.) it may or may not be advisable to use superglue to attempt to close a large wound.

[later edit: "large wound" this is a poor choice of words on my part, as it is too vague. one picture is in my mind, another "picture" may be in the mind of the reader. certainly, any wound penetraing deep tissue is not a candidate for closing. i could elaborate here, but the "Doc", who was kind enough to reply further on, with some very helpful and expert info covers it much better than i ever could - so, be sure to read his posts.]

sometimes it's just better to clean, disinfect, and cover it so that no dirt can get into it. you must then be careful crossing water sources (streams, rivers, etc.). if you can seal it in a plastic bag using duct tape to keep it dry while you cross the stream, that would be good.

also, next time you're at a doctor's appt, ask your physician for some pointers on cleaning, disinfecting, closing (using superglue), and bandaging wounds/cuts. have him show you how large/deep a wound you should attempt to close. obviously, these "Docs" are real pros at this (esp. ER/Trauma Docs - wish we had one or two particpating regularly in a Thread devoted to Wilderness First-Aid & Medicine - or a regular "column" in the BPL on-line mag; each month/issue covering a different aspect (with pictures!) of Wilderness First-Aid & Medicine).

after cleaning and disinfecting the wound and before applying the superglue, try to "line up" the edges of skin/wound to be "closed" so that the position of the skin looks as much as possible like it did before the wound [see the "Doc's" more explicit instruction in another post in this Thread about when it is advisable to try to "line up" the edges of the wound]. if you can use only one hand, it's a little difficult and you may need the assistance of a hiking "bud", if you're not out solo on that trek.

[note: a deep, penetrating wound should not be closed in the field as a pocket, susceptible to infection and which also won't heal quickly/properly may be left beneath the closed wound. see elsewhere for how to deal with a gaping or deep penetrating wound.]

after applying the superglue, hold the wound in postion for maybe 20seconds - it bonds real fast on skin. if too much glue came out, have a clean tissue handy & immediately just touch the excess with the tissue - it soaks in pretty quickly. if too much glue is NOT used on the skin, then it dries plenty fast. Best course of action if too much is used is to, once again, just touch the corner/edge of a piece of tissue to the excess glue to soak it up via capillary action. don't place the tissue flat on the wound/skin or it will end up sticking to the skin. you'll have to scrape it off & you don't want to do that on/around the wound (unless you've been bad and want to punish yourself).

the liquid superglue dries faster than the gel, but runs more easily & gets were it shouldn't (esp. if one is a klutz, like me). i've used both. don't get it or the concentrated fumes near plastic (many eye-glass lenses are made out of plastic. the fumes need to ventilate into a larger air volume. many plastics will be damaged by the concentrated fumes.

also, make sure that you and anyone else who will assist in cleansing, treating, and closing the wound disinfect their hands with alcohol gel, first, before coming near the wound. you should disinfect the area around the wound also.

well...'nuff said on superglue. hope you took notes. there will be a test later on.

hope this info helps some.
--------------------------------------------------------------
Roger, makes a good point on infection and drainage. for large or deep wounds, Dr's usually put one or more "drains" in the wound to allow fluid/serum, blood, and pus to drain from the wound. a drain can be nothing more than a strip of gauze. i've found that larger wounds open partly nearly daily or the next day if in an area that experiences a lot of movement (obviously if an ER had been handy & they were stitched/stapled then they wouldn't open). smaller wounds stay closed up to 3-4 days. smaller wounds are often not as deep, large, or long and easier to clean. while i've never had a wound become infected, it is a possibilty. remember to clean and disinfect before either closing and/or dressing the wound. you could also use wound closure strips or butterfly bandages to close a wound. this would probably be a real Dr's recommendation. in most cases, i prefer superglue as long as was stressed above the wound can be CLEANED and DISINFECTED properly. remember, the wound must be closed within 6-8 hours or it cannot be closed due to the much higher risk of infection. allowing the wound to heal without closing it will increase the healing time. exceptions to the 6-8 hour rule are the scalp & face. the rule there for wound closure is around 24hrs as i recall. there is more to wound treatment that is beyond the scope of this thread. so please, don't take this post as an all encompassing dissertation on wound care. talk to your Dr. or find a good book on backcountry/wilderness medicine. sorry, i can't recommend any book since i'm not familiar with any.

LET ME ADD ONE MORE THING HERE: there are times when emergency measures need to be taken which otherwise would be inadvisable. a decision needs to be made. sometimes it's the right one; sometimes the wrong one. this discussion has focused on ONE POSSIBLE decision in an emergency situation lacking more appropriate options. it's more a "what CAN be done." rather than under different circumstances a "is this really a good idea?" for example, if at home & can get to an ER is it advisable to boil fresh garlic & use the water to irrigate a wound? or, use honey to keep the wound sterile? or, use some sphagnum moss (contains low levels of iodine) to help combat infection? or, make a poltice out of "boneset" and/or other medicinal wild herbs? of course not. modern medical means are generally superior. my point is just that there are times to use both non-traditional or other methods that normally wouldn't be employed in a different environment. however, perhaps, in my hurry to post, i've explained this poorly. from the responses, apparently i have. my apologies.]

please don't understand this post to mean that superglue is a panacea for any and all trauma including, but not limited to cuttings, woundings, slashings, burnings, lacerations, abrasions, and penetrations. i feel that, under some circumstances it is an overlooked option. like, if i hadn't had superglue when i lost both big toe nails, i'd still be stuck in the deep woods and y'all wouldn't have the great displeasure of reading this post.

as 'Tigger' used to say: "TTFN - ta ta for now".

[note: i'm still not happy with some of the wording here in this post. i think perhaps some confusion results from such non-specific words, such as large, deep, small - these words mean one thing to a Med. Pro. & another to the hiker. to an ER Doc who sees this stuff frequently, what i'm calling large, might be considered to be minor/small. for me, if it happened at home & it requires a trip to the ER, it's more than minor. it's already far too long & adding more detail on "what constitutes large and small wounds" would only add to it. please be sure to read the "Docs" excellent comments further on. ]

Edited by pj on 10/13/2005 03:24:50 MDT.

Ryan Faulkner
(ryanf) - F

Locale: Mid atlantic, No. Cal
Re: Re: Re: Re: Re: my first aid gear list on 10/07/2005 14:58:51 MDT Print View

wow alot of valuble info, this convinced me to put a tube of superglue into my first aid kit

R Alsborg
(FastWalker) - MLife

Locale: Southwest
Re: Re: Re: Re: Re: Re: my first aid gear list on 10/07/2005 17:47:04 MDT Print View

I’d reconsider super-glue as a first aid item.

If you use super glue to seal a wound say even a minor laceration and infection set-in it would have no way to drain. The wound would have to be re-opened most likely surgically to be cleaned.

Edited by FastWalker on 10/07/2005 17:49:21 MDT.

David Lewis
(davidlewis) - MLife

Locale: Nova Scotia, Canada
Re: Re: Re: Re: Re: Re: Re: my first aid gear list on 10/07/2005 20:55:02 MDT Print View

I agree it's really only for small cuts. I learned it years ago as a musician... for closing very minor, very clean surface cuts of the type you might get when chopping veggies or something. Musicians use super glue because it allows you to still play... i.e... it can be hard to fret a guitar or play a violin or whatever with a big bulky bandaid on your finger. Still... I think it's a good thing to take with you to at least have as an option... it can take over if you run out of bandaids.

paul johnson
(pj) - F

Locale: LazyBoy in my Den - miss the forest
Re: Re: Re: Re: Re: Re: Re: Re: my first aid gear list on 10/08/2005 01:15:21 MDT Print View

[edited to remove info not pertinent to this thread.]

Roger & David,

for you and i & most (all???) others in these Forums, superglue is for what might be termed "minor" cuts. i've used it several times (on myself) for things a bit more than minor. each of these times i'm thinking of were because i did not happen to have a suture kit and couldn't get to an ER for a small number of stitches. i've seen surgeons, more than once, use it in the O.R. for closing the skin of surgical incisions (me being one of their patients). in my case, one long "zipper" was stapled w/two drains; others were glued w/o drains. i have once seen it used, a number of years ago, on a longer incision - again by a real surgeon. THESE WERE SURGEONS HOWEVER (not you, me, or the typical UL backpacker). REAL PROS (the Chinese have this saying about "yi sheng", i.e. "doctor", viz. "muao shou hue qen", meaning "the hands that heal are like spring" - i'm sure the analogy of "spring" & "new life" is understandable). i sure wouldn't have attempted to glue the large one (neither did they). amazing to watch how they work with the "material" of the human body.

bottom line: limit superglue use to the situation, type of wound, and medical skill of the user. so, "kids, don't try this at home" is my penultimate advice.

caveat: my final advice on this matter: most of us think that we are better at something than we are. so, beware (i tell myself this all the time. so, i'm only giving advice to others that i've given myself thousands of times).

ok. i lied. my real final advice: for ANY cut or wound, CLEAN, CLEAN, CLEAN, and DISINFECT the site of the injury real well (also disinfecting your hands and the general area around the injury first before going to work on the wound) before closing (using butterflys, closure strips, or superglue) OR even just bandaging. oh...and check it daily for signs of infection (inflamed, swollen, redness, warmth, pus - of any color).

[note: this post is a bit vague on this point of "closing", so please see comments in other posts regarding "closing".]

Edited by pj on 10/13/2005 03:26:44 MDT.

R Alsborg
(FastWalker) - MLife

Locale: Southwest
Re: Re: Re: Re: Re: Re: Re: Re: Re: my first aid gear list on 10/08/2005 01:44:24 MDT Print View

Thanks Paul for the free medical advice & Chinese proverb….

But I’ll stick with an Antbiotical Ointment (Neosporin 0.5oz tube) and adhesive BAND-AID’s.

Regards,
Fastwalker

jacob thompson
(nihilist37) - F
I'm with Paul on this one on 10/08/2005 01:58:10 MDT Print View

It should always depend on the situation. If I thought I needed more than 2 or 3 stitches I would probably use them but if I can get away with it I would rather not see an emergency room. Paul is absolutely right though CLEAN and Sterilise before you do anything. I barely ever cut myself but when I have I've been known to go completely overboard on sterilising and cleaning the wound. To this end of never had a bad cut get infected.

Like I've said in previous posts I'm a long term barefooter and only really wear shoes if I go with my friends to a bar or I have to do practicals in laboratories. In RJs book he mentions that he often uses SG to bind cracks in his feet. I'm guessing that I have reasonably oily feet since I don't have the cracks that he talks about. However I will definitely be bringing it on my PCT thru-hike since I'm sure it will come in handy.

Paul - That's really interesting that you got to watch your own operation. I have 6 weeks left of my undergrad in biology and though my interest is more in insect ecology a little bit of human anatomy would have been really interesting to watch. I've never needed to have any surgery (touch wood) but if it came to the point were I absolutely had to I think I would go the same way as you and watch the operation. I'm sure you learned more about human anatomy that way than through any amount of text book reading.

paul johnson
(pj) - F

Locale: LazyBoy in my Den - miss the forest
Re: Re: Re: Re: Re: Re: Re: Re: Re: Re: my first aid gear list on 10/08/2005 02:03:42 MDT Print View

[edited to remove info not pertinent to this thread.]

Roger,

thanks for the cautionary reply. i appreciate it. it's always good to have a "kids, don't try this at home" side to such things. so, let's just leave it at, i recommend that you can use superglue to close smaller, more minor paper cuts - a wound that isn't cut into deeper tissue. anything beyond that does NOT have my blessing (as if anyone really needs or wants that), and you do it at your own risk.

also, hope you understood that antibiotic ointment is to be used at all times and that my advice did not obviate the need for it (viz., and i quote from my prev posts, "DISINFECT"). but thanks again for bringing it up - it (viz. cleaning and disinfecting) is perhaps the most important aspect of first-aid wound care.

one needs to know their limitations in order to keep out of trouble. the same could be said for first-aid. learn and train before doing.

Edited by pj on 10/09/2005 12:10:02 MDT.


(Anonymous)
With all due respect on 10/09/2005 05:24:57 MDT Print View

who would recommend putting aqua mira in a wound, especially by itself. And closing a wound in the backcountry should be left to someone with proper training. Depending on wound depth, many should not be closed in the backcountry. Taking off that duct tape could reopen a wound. Be careful in your choices.

Ryan Faulkner
(ryanf) - F

Locale: Mid atlantic, No. Cal
Re: With all due respect on 10/09/2005 07:16:13 MDT Print View

First of all I have other things I would use first and save duct tape for a desperate situation, andmostly just use it as a replacement for moleskin. and second you trust aquamira to be not poisonus and to kill the bacteria in your water why not in your wounds


(Anonymous)
Re: With all due respect on 10/09/2005 11:44:50 MDT Print View

I think that the other post was saying that the duct tape is meant to hold a plastic bag on to prevent water from wetting a wound that should not get wet. It did not say to put the duct tape on the wound. Read a little more carefully in the future.

paul johnson
(pj) - F

Locale: LazyBoy in my Den - miss the forest
Re: With all due respect on 10/09/2005 13:37:45 MDT Print View

Anon,

thanks for taking the time to weigh in here.

most of the people who participate in these forums know that duct tape is not put directly on a wound in place of a bandage. i don't think that anyone meant that. hold a bandage on - yes. cover a bandage to seal it against water penetration - yes (if no other way exists to accomplish this). affix a piece of plastic over a bandaged wound to prevent water penetration - yes (let me be clearer here: in this case the tape holds the plastic against undamaged skin - not the bandaged wound).

they also know that AqM should not be reacted and then poured full strength into a wound. a lot of tissue damage would probably occur. a good procedure is to use AqM to disinfect some water & then use that disinfected water to irrigate the wound thoroughly.

as far as "closed". i guess it would depend upon the size/depth of the wound, the method of closing. as you undoubtedly know, the longer a wound is left open, the more likely it is to become infected. so, i would say that there are some wounds that should be closed which otherwise when at home should wait until a trip to the E.R. if one has to hike a day or two (or even 8-12hrs) out to receive professional medical assistance, maybe it's better to close the wound in the field and then hike out to obtain professional medical care. if it's over 6 to 8 hrs (~24 hrs for scalp & face), it's not going to be closed by a Doc in an E.R. later on. deep, penetrating wounds are generally better off not being closed in the field - just clean, disinfect, pack, cover, and stabilize. your post is right on in these cases.



>>"proper training"
you hit the nail on the head. thanks for stressing that point. i believe that i mentioned that in my first post (at least, i hope i did - i type these things too fast).


i think the types of situations envisioned here are those in which the choice is: 1) to do nothing (which in these scenarios is a bad thing) or 2) improvise. [see my first post for more improvisations] even using duct tape cut into thin wound closure strips is OK in this type of emergency. placing rows, or random punctures (perhaps using a sterilized safety pin - most of us are carrying alcohol or another means of disinfecting the pin) in the tape is advisable before applying the narrow "wound closure duct tape strips" perpendicular to the length of the wound (prevents fluid/serum/sweat/oil buildup under the tape). this, however, is a far cry from placing a 2" wide strip of duct tape over a wound, entirely covering it. no bandages? clean and disinfect a piece of cloth cut off of a clean piece of clothing. spread antibiotic ointment on it, or soak in water disinfected with AqM and place it on the wound and then hold in place or cover with duct tape.

no duct tape? if superglue is handy, strips of cloth can be glued (at each end of the strip only) perpendicular to the length of the wound.

hey...maybe i'm wrong here, but i don't see any reason why shallower cuts, those not penetrating into deep tissue, in many cases (not all cases) can't be closed (after cleaning/irrigating and disinfecting) using just superglue. i've done this a number of times myself. in one case, it sure prevented any dirt from getting into a wound on my hand (i know bad idea - but, it's what i decided to do for/to myself, NOT advice i'd give to others). when hiking/climbing we use our hands so much that sometimes it's difficult to keep a bandage on a wound on the hand (in part, this is due to the fact that as UL backpackers we don't carry the equivalent of a Marine Corpsman's B-1 kit into the field with us). if appropriate, closing that wound with superglue and then covering it with a band-aid can prevent contamination of the cleaned & disinfected wound. if you feel i'm wrong, please educate me and tell me why and what you would do in this case (e.g. hike out keeping the wounded hand in your pocket the entire time? or some other more plausible course of action). oh..in this case, i did seal the entire cut with superglue (didn't want anything to get into it); also had to reapply it each day. other times, have "tacked" a cut closed with a series of drops or broken lines of superglue - functioning sorta' like wound closure strips. while i've had infected wounds, i've never had a cut closed with superglue become infected (always clean/irrigated and disinfected it extremely well before closing). that's NOT to say that a cut closed with superglue can't become infected (in fact, if it does become infected, it can be very bad - the superglue should be removed immediately in this case).

of course, any infected wound should not be closed. it needs to be left open to drain.

as was stated in a prev. post: learn and train before doing (i think this is a point you made well also). basic and advanced first aid courses are really a must for anyone spending a great deal of time in the field, IMHO.

what we really need here is a real Doc to give advice (preferably an ER or Trauma Doc; even better, one with either Military Service or 3rd World Medical Missionary experience who knows how to improvise and think outside of the box - one who doesn't immediately think one must be the spawn of the devil for recommeding that there may be times when sphagnum moss will need to be used as a poltice to prevent infection). keep in mind, in the field sometimes we must improvise when the proper equipment is not available. doing nothing is sometimes an option. at other times it is not an option. please help us with guidelines as to when doing nothing is preferable to improvising.

if you're a Doc, please help us out here. please provide some construction to go along with the criticism. many thanks, pj

Edited by pj on 10/13/2005 03:35:59 MDT.

Jay McCombs
(jmccombs) - MLife

Locale: Southwest
tips on 10/09/2005 14:45:24 MDT Print View

Knowing when to close a wound is an art. Its something learned through years of seeing varrious wounds and the decision is multifactorial. Location, how the wound was inflicted, size and depth, shape, amount of vasculature to wound, etc. all play roles. All wounds in the backcountry are "infected" in that they are teaming with large amounts of bacteria etc. so making that distinction is not worthwhile. Here are my tips, with no attached credentials for fear of vultures (lawyers).

1) Stop the bleeding with direct pressure from a sterile bandage.

2) Clean it. This should be a no brainer. No matter the type of wound, get it clean. Sterile water is fine. Soaps, alcohols, hydrogen peroxide, etc. don't offer any additional advantage and cause additional tissue damage that can delay wound healing. Flushing the wound with copious clean water will generally be ample. The goal is to wash out any debris (dirt, etc) visible to the naked eye. Use copious water and remove any chunks of stuff if possible. Cutting skin off is at your own risk and should be done on a "per skill" basis, so for most people that means just leave it alone.

2) "No wound should be sutured by an individual who is inexperienced in basic surgical technique. Additionally, no wound incurred in the wilderness is truly risk-free regarding infection. In general, the safest management strategy for lacerations in the wilderness setting is open management or closure with nonsuture alternatives"

That is, if you aren't a doctor you probably have no business sewing someone up and doing so in the wilderness would generally not be advised.

Tape/steri strips are the best choice. Its easy to use and cheap. The goal of wound closure is to get the skin back aligned in its original position. If you are missing big chunks of skin you probably shouldn't try and stretch it back closed.

Octylcyanoacrylate and similar synthetic agents are decent second choices too. These things can always be undone. If you have a wound that you think requires a drain you need to get out of the woods. Control bleeding and get professional help ASAP.

Puncture wounds should not be closed in the field under any circumstances and should be considered "trip enders" a couple extra days in the woods aren't worth your life. Control bleeding, pack large wounds with STERILE gauze and get out safely and quickly. You can always head back out after having the wound properly evaluated and treated.

Wounds on the hand are also high risk type wounds. Controlling bleeding should be your primary goal. Next is irrigation. Finally, open wound management (cover it with a clean dressing and keep it clean) or closure with steri strips or the like is the third goal. I could give youa list of ideas for when to close and when to open, but the best advice I can offer is if the original architecture of the skin can be restored, ie the wound is a clean slice and the edges can be approximated to their original position, close it. Otherwise, open management is probably the best bet.

Take this as the advice of some random backpacker off the internet please.